A pro-inflammatory diet in people with multiple sclerosis is associated with an increased rate of relapse and increased FLAIR lesion volume on MRI in early multiple sclerosis: A prospective cohort study
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Date
2023
Authors
Saul, A.M.
Taylor, B.V.
Blizzard, L.
Simpson-Yap, S.
Oddy, W.H.
Shivappa, N.
Hébert, J.R.
Black, L.J.
Ponsonby, A.L.
Broadley, S.A.
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Journal article
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Multiple Sclerosis Journal, 2023; 29(8):1012-1023
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Alice M Saul, Bruce V Taylor, Leigh Blizzard, Steve Simpson-Yap, Wendy H Oddy, Nittin Shivappa, James R Hébert, Lucinda J Black, Anne-Louise Ponsonby, Simon A Broadley, Jeanette Lechner-Scott and Ingrid van der Mei, Ausimmune, AusLong Investigators Group
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Abstract
Background: A pro-inflammatory diet has been posited to induce chronic inflammation within the central nervous system (CNS), and multiple sclerosis (MS) is an inflammatory disease of the CNS. Objective: We examined whether Dietary Inflammatory Index (DII®)) scores are associated with measures of MS progression and inflammatory activity. Methods: A cohort with a first clinical diagnosis of CNS demyelination was followed annually (10 years, n=223). At baseline, 5- and 10-year reviews, DII and energy-adjusted DII (E-DIITM) scores were calculated (food frequency questionnaire) and assessed as predictors of relapses, annualised change in disability (Expanded Disability Status Scale) and two magnetic resonance imaging measures; fluid-attenuated inversion recovery (FLAIR) lesion volume and black hole lesion volume. Results: A more pro-inflammatory diet was associated with a higher relapse risk (highest vs. lowest E-DII quartile: hazard ratio=2.24, 95% confidence interval (CI)= −1.16, 4.33, p=0.02). When we limited analyses to those assessed on the same manufacturer of scanner and those with a first demyelinating event at study entry (to reduce error and disease heterogeneity), an association between E-DII score and FLAIR lesion volume was evident (β=0.38, 95% CI=0.04, 0.72, p=0.03). Conclusion: There is a longitudinal association between a higher DII and a worsening in relapse rate and periventricular FLAIR lesion volume in people with MS.
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First published online May 6, 2023
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© The Author(s), 2023. Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Article reuse guidelines: https://au.sagepub.com/en-gb/oce/journals-permissions